A future of certain doom

A mural in Gaza city depicts a closeup of realistic eyes as children peek out from a window embedded in the mural

Schizophrenia and depression are among the most common mental health issues in Gaza, and Gaza’s only government-run mental health facility is in no state to expand treatment.

Mohammed Asad APA images

It was 2 am when I woke up with severe pain in my right eye. I’d never experienced anything like it.

The pain tightened around my eye and then expanded to encompass the whole right side of my head. It was late 2021, and I was experiencing my first migraine. The pain was so intense I couldn’t even move to get a painkiller, much less turn on the light to find one.

This pain became routine as I grew accustomed to monthly migraines: dizziness to the point of nausea, extreme sensitivity to light and sound. But when they became even more painful and more frequent, I visited a neurologist.

The doctor questioned me about my life. About my family, my emotional state, my work. When I told him I was a journalist, it seemed to clarify my situation for him.

He said that the migraines could be a symptom of the intense emotional stress and trauma I’d experienced. He said that depression was a common condition of people in this line of work.

Reporting on war

I’ve worked as a freelance journalist since 2017. But the first war I reported on was in May 2021.

That month, Israel killed over 250 people. An Israeli airstrike destroyed two residential buildings on al-Wihda street, killing 42 people alone.

I reported on the war from my family’s kitchen, the safest room in our house as Israel dropped bombs all around us. We live near the sea, and the Israeli navy had stationed ships off the coast that were prepared to launch missiles. I could barely focus on my work knowing that we could die at any moment.

During Israel’s attacks, I met survivors of bombings, spoke to children who had lost their parents and to a woman who had lost her fiance.

When the war was over, I covered its aftermath: all the destruction and the chaos that Israel had left behind. I did this for eight months – report, write, file stories – until it was too hard to carry on.

Outside of work, I couldn’t do any of my usual tasks, like going to the gym, chatting with my sister in Turkey and my brother in Australia or reading books.

On most days, all I wanted to do was sleep. I was in a major depression for at least a month. But it was not only the war that led to my depression.

A few months before the war, my uncle died from cancer. Though he occasionally received Israeli-approved medical travel permits, he was frequently rejected, as so many Palestinians are. He could barely afford much-needed medicine on his teacher’s salary. And, shortly before his death, when the cancer metastasized throughout his body and he became paralyzed and lost the ability to speak, I was heartbroken.

Lack of mental health facilities

There are not enough mental health facilities in Gaza to treat the number of people who need care.

Jamil Suleiman, director of the health ministry’s mental health department in Gaza, estimates that 70 percent of Gaza’s population, or around 1.5 million people, urgently require therapy as a result of the strain of living conditions produced by Israel’s 16 years of siege.

Suleiman said that despite the increased rates of mental health issues among Palestinians in Gaza City, the city lacks public mental health facilities, and most hospitals do not have dedicated departments for mental health.

Schizophrenia and depression are the most common mental health issues in Gaza, Suleiman said, and Gaza’s only government-run mental health facility, the Community Psychological Rehabilitation Center, is in no state to expand treatment.

The facility needs major development and expansion, he said, as it has only 39 staff members and runs at a capacity of 50 beds.

Gaza’s medical sector has largely relied on foreign financial assistance to stay afloat, but regardless of this aid, the situation of mental health treatment in Gaza is dire, with shortages in medications and a lack of adequate staffing on all fronts.

Seeking financial stability

All the circumstances that can buffer the harshness of depression – financial stability, predictable futures, steady relationships – are harder to come by in Gaza.

I’d been saving money for a year to start my own clothing business. After years of freelance journalism and content writing, I’ve learned it’s not always the most reliable source of income, and I thought starting my own business would be the best way to feel secure, happy and stable.

Seven months ago, I opened my online clothing store and dove headfirst into the work. Yet sales were weak and costs mounted.

Gaza is not a booming market for this kind of business, so I returned to journalism, hoping to save more money to try again and open the business as a storefront.

With these stresses and unknowns, my migraines and depression have intensified. But that’s not everything. Four months ago, I started taking antidepressants to help me concentrate on my work as I am preparing to travel to Turkey at the end of the year to study Turkish and continue my international journalism master’s degree there.

It is so difficult to imagine emerging from a depression in Gaza when the future feels like certain doom.

My cure-all

I do have one spot where I go to de-stress.

Al-Baqa Cafe on the Gaza seashore has become my second home. Sometimes I stay until sunset, feeling hopeful about what, on most days, I see as a grim future.

At al-Baqa, I feel cut off from the dreadful reality of Gaza’s surroundings. I have rare moments of what feels like peace and tranquility.

In the morning the cafe plays Fairouz. I listen to the waves and drink my coffee, looking out at the activity of the sea: birds flying, fishers casting their nets, boats docking at the port. Friends sometimes join me here. We catch up on work and life, sing songs, play cards. We take walks along the coast to the port, delaying the return home.

Khuloud Rabah Sulaiman is a journalist living in Gaza.